Prevalence and risk factors for modified prescriptions in an Irish community pharmacy

Background

Little research exists of rates of prescribing errors and prescription modifications, or risk factors for same, in Ireland.

Methods

A cross-sectional study was performed to examine prescriptions dispensed in a community pharmacy over a period of 5 weeks from November 19 to December 21 2012.

Results

In total, 866 prescriptions were examined. The overall prevalence of prescription modifications was 17.9% (155/866), with a mean of 31 modifications per week. Prescription only medicines (POM) comprised 147 (94.8%) of the modifications, 128 (87.1%) of which concerned a prescription error requiring a simple clerical clarification before dispensing could occur, with the remaining 19 (12.9%; average of 3.8 per week) potentially having clinical consequences if left unaltered. Half (51%) of all POM modifications occurred through consultation with the patient or their representative. The following factors were associated with increased risk of POM modifications: being a female patient (OR = 1.605, 95% CI 1.104-2.333, p = 0.013) and being prescribed drugs in the following therapeutic areas: musculo-skeletal (OR = 1.906, 95% CI 1.023-3.551, p = 0.042) and genito urinary system and sex hormones (OR = 3.691, 95% CI 2.255-6.042, p< 0.001). Multivariate analysis showed these were significant independent determinants of POM modifications, remaining so after adjustment.

Conclusions

The majority of prescribing errors modified involved non-serious clerical errors. However an average of 3.8 POM prescriptions with potential clinical consequences were modified weekly.